• Yoshie Shibata, Daisuke Shigemi, Marie Ito, Kayoko Terada, Kazuho Nakanishi, Masahiko Kato, Miwa Igarashi, and Shunji Suzuki.
• Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital.
• J Nippon Med Sch. 2014 Jan 1;81(2):94-6.

Objective And MethodsWe examined the relationship between low fibrinogen levels (<200 mg/dL) and the severity of postpartum hemorrhage in singleton vaginal deliveries after 22 weeks' gestation complicated by postpartum hemorrhage requiring transfusion at our hospital.ResultsDuring a 10-year period, 61 women (0.38%) received transfusions owing to postpartum hemorrhage within the first 24 hours after delivery. Of these women, 13 (21%) had low fibrinogen levels (mean, 123 ± 68 mg/dL) when postpartum hemorrhage was diagnosed, and the other 48 (79%) had normal fibrinogen levels (mean, 305 ± 50 mg/dL). Neither total blood loss nor the incidence of additional therapies, such as hysterectomy, differed between the 2 groups of women. Women with low fibrinogen levels started to receive transfusions significantly earlier (98 ± 58 minutes after delivery) than did women with normal fibrinogen levels (142 ± 75 minutes after delivery, p=0.03) and received more units of fresh-frozen plasma (p=0.03).ConclusionThe early transfusion of fresh-frozen plasma in women with postpartum hemorrhage and low fibrinogen levels might help prevent adverse outcomes.

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